Abstract
Hepatocellular carcinoma (HCC) is an aggressive tumor, and sorafenib is the only proven drug for treating advanced HCC with limited survival outcome. We present a case of severe right lower chest pain in a 54-year-old man. A computed tomography (CT) scan revealed liver cirrhosis and multiple HCCs with inferior vena cava invasion, regional nodal and right adrenal metastases, and hemoperitoneum. His hepatitis B virus (HBV) deoxyribonucleic acid (DNA) level and alpha-fetoprotein (AFP) remained high even after transcutaneous arterial catheter embolization for ruptured HCCs. He received combination therapy of entecavir, sorafenib, nivolumab, cisplatin, and PG2 injection. The follow-up positron emission tomography-CT confirmed no tumor in the liver, and alpha-fetoprotein and HBV DNA titers showed a promising decrease. This novel combination had encouraging therapeutic effects for advanced HCCs, which decreased viral replication without side effects.
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